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Title: ADHD and Iron Deficiency
Author: Anthony Kane, MD
Website: http://addadhdadvances.com
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ADHD and Iron Deficiency
by Anthony Kane, MD
About 8% of children, ages 4 years and under, are deficient in
iron. Between the ages of 5 and 12, the percentage rises to
13%, and then settles back to 8% in people above the age of 15.
Anemia is the best-known repercussion of iron deficiency.
However, even minor deficiencies in iron may weaken the immune
system, affect the thyroid, and impair general physical
performance. Iron deficiency has also been implicated in a
number of psychiatric and neurological conditions, including
learning disabilities and ADHD.
Iron is a co-enzyme in the anabolism of catecholamines. That
means it is essential for the creation of certain
neurotransmitters. It helps to regulate the activity of the
neurotransmitter dopamine, which probably accounts for the
association of iron deficiency with neurological problems. It
makes sense that supplementing ADHD children, who have some
level of iron deficiency, might have some effect on their ADHD.
However, what makes sense in theory, does not always work in
practice. Unfortunately, there have been very few studies done
testing the effects of iron supplementation on ADHD.
One study, done in Israel, evaluated 14 ADHD boys for the
effect of short-term iron administration on behavior. Each boy
received iron daily for 30 days. Both parents and teachers
assessed the behavior of the children. The parents found
significant improvement in the behavior of the children.
However, the teachers noticed no improvement.
In a second study, 33 iron-deficient, but otherwise normal,
children were given an iron supplement. The children became
less hyperactive. This study suggests that iron deficiency may
cause hyperactive behavior in some children and that hyperactive
behavior is reversible when the deficiency is treated.
A third study tested the affects of iron supplementation on a
group of teen-aged high school girls who were determined to be
iron deficient. At the end of the 8-week study, the researchers
found that girls who received iron supplementation performed
better on verbal learning and memory tests than those who did
not.
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This is about all the evidence we have. It’s not a lot and it’s
not very impressive. None of the studies were double-blind
studies, which means we cannot really rely on them all that much.
If this were the only consideration, I would say you should
definitely try to treat your child for iron deficiency. The
reason is that hyperactive children are more likely to be iron
deficient than other children. Also, there is a possibility
that your child has a higher than average iron requirement.
That means that he might test normal on all the iron blood tests
and still be iron deficient because he requires more than the
average amount of iron.
So why not just give your child iron supplements and see what
happens? Because iron functions in the body like a two edged
sword.
Iron exists in the body in two chemical forms. There is the
ferrous form, where the iron atom will bond to two electrons
and the ferric form where the atom will bond to three electrons.
Iron can go back and forth between these two forms. This is
the property of iron that allows it to play a role in carrying
oxygen as part of hemoglobin. However, it also makes iron an
active player in oxidation-reduction reactions. What that means
is that iron has the ability to act like a free radical and
cause significant damage to tissues. Whenever iron is not bound
to hemoglobin or to some other carrier protein, it travels
around the body as free iron and can cause damage anywhere it
goes. To further exacerbate the problem, excess iron is not
eliminated well by the body. Most of the iron in the body gets
recycled. Therefore, not only is excess iron toxic, but also
once you have excess iron in your body, it is going to stick
around for a long time. High amounts of iron have been found
in the brains of people with Parkinson’s disease. It is very
likely that excess iron can aggravate, if not cause, other
neurological problems as well.
With that in mind we have to approach iron supplementation with
caution. My feeling is that if your child turns out to be one
of the 8-13% that is deficient in iron, it is worth giving
iron supplements. I doubt that it will help much with his
ADHD, but it should help with his general health. This advice
applies to your non-ADHD children, also.
How should you test iron deficiency? The hemoglobin and
hematocrit counts that come as part of the standard complete
blood count (CBC) are good for diagnosing anemia. They do not
really give you accurate information about the body’s iron
status. The best test for iron status is the serum ferritin
test, which measures how much iron is stored in your body. It
will be low if you are deficient and high if you are overloaded.
If you find your child has an iron deficiency problem, there are
several approaches to treat it. Probably the safest is by giving
him more iron-containing foods. You can serve him red meat
several times a week. Liver is an excellent source, if you can
get him to eat it. You can enhance dietary absorption by
supplementing with vitamin A (about 10,000 IU) and vitamin C
(about 500 mg) with the meals.
The most likely the reason that your child is deficient is
because he is a poor eater; so, dietary intervention may not be
practical. A second and far inferior source of iron is through
supplements. The primary difficulty of iron supplements is
that they do not get into the body. Fortifying foods with iron
in general does not work. Many foods bind iron and, as a
result, the iron is excreted rather than absorbed. The best
form of supplemental iron is Ferrochel. Ferrochel is an amino
acid chelated iron, which is highly bio-available and is not
affected by foods that bind iron.
Most iron supplements have a ten percent absorption rate. That
means if you take 10 mg of the supplement, your body absorbs
1 mg. Ferrochel is different. Ferrochel has a 75% absorption
rate. That means 1.5 mg of Ferrochel provides more iron to
your body than 10 mg of other supplements.
That is an interesting fact, but it is not why I am recommending
it. The more important property of Ferrochel is that since it
is already amino acid bound, it does not become free iron in
the body. That means it does not have the dangers and side
effects of other iron supplements. The FDA has given Ferrochel
the designation of GRAS, (generally regarded as safe). No other
iron supplement has this designation.
The take home message is that iron deficiency may be the cause of
hyperactivity in some children. It is worth your while to have
your child tested. If for some reason you suspect your child is
iron deficient, the best approach is to increase your child’s
iron intake through his diet. If that doesn’t work and you need
to use supplements, the best supplemental iron is Ferrochel.
Anthony Kane, MD
ADD ADHD Advances
http://addadhdadvances.com
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Anthony Kane, MD is a physician, an international lecturer, and
director of special education. He is the author of a book,
numerous articles, and a number of online programs dealing with
ADHD treatment (http://addadhdadvances.com/childyoulove.html),
parenting issues (http://addadhdadvances.com/betterbehavior.html),
ODD, and education.
You may visit his website at http://addadhdadvances.com.
To sign up for the free ADD ADHD Advances online journal send
an email to: subscribe@addadhdadvances.com?subject=subscribeart
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